Book Review

MAXX: The electronic library of medicine on CD-ROM

N Engl J Med 1997; 337:1249-1250October 23, 1997

Article

MAXX: The electronic library of medicine on CD-ROM
CD-ROM, with manual, 21 pp. System needed: Multimedia IBM PC or compatible computer, with at least 4 MB RAM. (Also available for Macintosh System 7.0 or higher, with at least 4 MB RAM.) Philadelphia, Lippincott–Raven, 1997. $395 (single user). ISSN 1092-1508 (WIN).

For many physicians, the Little, Brown Spiral Manuals have eased the stress of their first days at a new internship or residency; the well-known “Washington” manual has been a friend in numerous near-panic situations throughout internship. Some of us still carry one of these manuals in our coat pockets to this very day. In recent years, there has been a steady proliferation of Little, Brown Spiral Manuals on subspecialties. At present, such specific manuals as The Manual of Pediatric Emergencies, The Manual of Dermatologic Therapeutics, and The Manual of Toxicology accompany fellows and subspecialists throughout internal medicine, emergency medicine, and intensive-care units. There are now more than 25 titles, covering 20 medical specialties, with a total of more than 17,000 pages.

MAXX (“maximum access to diagnosis and therapy”) contains, on a single CD-ROM, the entire Little, Brown Spiral Manual series. Besides the numerous specialty-oriented manuals, this CD has two additional titles — namely, Wallach's Interpretation of Diagnostic Tests and A Pocket Manual of Differential Diagnosis. These additional reference sources are often needed during routine work when clinical problems are encountered.

To operate most of the features of this CD, a half-hour or so to read the concise printed manual would be sufficient. Occasionally, one might have to consult the on-line help feature, which also includes a highly recommended tutorial. When the package is run for the first time, the initial screen displays the front pages of the manuals in an icon format. By clicking on any of these small images, one gets the full text and illustrations of the requested manual. The most important advantage of having all the manuals on a single CD is the ability to search through the entire data base — all 17,000 pages — at one time. Thus, the retrieval set of a single query may span several different manuals. For example, material relevant to amyloidosis was found in 21 manuals, including Clinical Oncology, Nephrology, and Allergy and Immunology.

It is possible to gain access to images, tables, and related chapters simply by clicking on each highlighted hyperlink entry. Multiple electronic bookmarks and “sticky notes” can be attached to the text, while sections of the text can be permanently (but reversibly) highlighted. A very useful feature is the ability to print sections of the text. Think how handy and impressive it would be to be able, in a matter of seconds, to extract the entire differential diagnosis for a patient with hypomagnesemia, as well as the treatment options, for an informal discussion in routine rounds or, alternatively, to be able to place this useful information in the patient's file.

This CD can be a valuable addition to routine patient care in several key locations of the hospital. In various emergency settings, be it an emergency room, an intensive-care unit, or the office of a primary care physician, this very practical yet powerful reference source could be life-saving. In addition, those conducting teaching and grand-round forums may find this data base an authoritative source of information and its on-line capabilities useful.

In contrast to the didactic and comprehensive coverage of standard textbooks, the Little, Brown manuals provide concise and highly focused medical information in a most practical and ready-to-use format.

Daniel Mimouni, M.D.
Beilinson Medical Center, Petah-Tiqva, 49100 Israel

Eytan Z. Blumenthal, M.D.
Hadassah University Hospital, Jerusalem, 91120 Israel